Diagnosis of Neurogenic LUT Dysfunction after SCI

and Apichana Kovindha²

(1)

University of Antwerp, Antwerp, Belgium

(2)

Rehabilitation Medicine, Chiang Mai University, Chiang Mai, Thailand

Information on the remaining innervation of the LUT after SCI should be acquired from history taking and clinical neurological examination. How many investigations are needed depends on each individual patient, the stage of SCI management (acute phase, post-acute rehabilitation phase, long-term phase of follow-up) (Table 3.1). This will also help determine which tests should be done and when, and if a test should be repeated.

Table 3.1

Urological investigations to be done during the acute, the spinal post-acute rehab, and follow-up/long-term phases

	Acute phase	Post-acute rehab phase	Post discharge Follow-up/long-term phase
General history	+	+	+
More specific/relevant history		+	+
Physical examination	+	+	+
Neurological examination	+	+	When indicated
Urine tests	+	+	+
Blood analysis	+	When indicated
Urodynamic testing (UDT)		+	When indicated
Imaging	+	+	+
Specialized urological tests	When indicated

+, recommended to do

3.1 Patient History

Primary general history taking should be started with a quick overview of the patient’s condition: age, gender, race, general condition, possibility to communicate with reference to language, cognitive abilities, functional level, motivation, cooperation and psychological status.

Further history taking should explore previous diseases of the urinary tract, drug intake, techniques of bladder drainage used and eventual problems which occurred, urinary tract infection (UTI) and other LUT complications. An assessment of sexual, and bowel functions should also be included as there is an important overlap of innervation of the different pelvic organs, and a strong interaction between them [4].

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